The Risk of Mortality in Patients Undergoing Elective Primary Total Hip Replacement for Osteoarthritis With Recent Inpatient Admission for Management of Medical Conditions, Analysis of the National Joint Registry

Description

In this presentation, Jonathan Evans discusses the implications of co-morbidities in patients awaiting hip replacement surgeries. He begins by acknowledging the effectiveness of hip replacements, noting the increasing number of patients on waiting lists, which can lead to the development of additional medical issues while patients await surgery. The focus is on understanding the mortality risk associated with new co-morbidities identified through linking the National Joint Registry with hospital episode statistics, specifically for patients with osteoarthritis requiring total hip replacement.



Evans highlights the substantial mortality risk for patients who develop acute conditions like myocardial infarction (MI) shortly before undergoing hip replacement, revealing alarming statistics such as an 18% chance of death compared to the overall 0.34% mortality rate for hip replacements. He elucidates various co-morbidities, asserting that patients with existing heart conditions face significantly higher risks, and underscores the need for awareness and possible adjustments in treatment protocols.



The discussion culminates in the suggestion that patient consent may need to include the risks associated with these new conditions. Evans concludes by proposing a guideline for managing patients who develop co-morbidities while waiting, suggesting a six-month observation period before proceeding with surgery to mitigate risk. With the aim of improving patient outcomes, he emphasizes the necessity of adapting clinical practices based on these findings.

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